HomeMy WebLinkAboutPK13-118 - Original - ASA Umpires Association - Adult Slowpitch Softball Unpiring - 04/01/2013 Records Man-,\11.1,7000 gemera:
KENT Document
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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: King County ASA Umpires Association
Vendor Number:
JD Edwards Number
Contract Number: log/ 3- � � g
This is assigned by City Clerk's Office
Project Name: 2012 King County ASA Umpires Association
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 4/1/2013 Termination Date: 9/30/2013
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Dave Heldt Department: Parks - Kent Commons
Detail: (i.e. address, location, parcel number, tax id, etc.):
tpetrole
s Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
5
KENT
WABHINGTON
GOODS & SERVICES AGREEMENT
between the City of Kent and
King County/ASA Umpires Association
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
corporation (hereinafter the "City"), and King County/ASA Umpires Association organized under
the laws of the State of Washington, King County, located and doing business at 605 Cedar DR
SE, Auburn, Washington (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following
services for the City:
Description: Adult Slowpitch Softball Umpiring
Start time/Duration/Stop Time: April 1, 2013 to September 30, 2013
Event Location: City of Kent and Kent School District Athletic Fields
The vendor agrees to credit the City of Kent $20.00 and one (1) dozen approved
softballs for failure to provide umpire services for a scheduled game, per
occurrence.
Vendor acknowledges and understands that it is not the City's exclusive provider of these
goods, materials, or services and that the City maintains its unqualified right to obtain these
goods, materials, and services through other sources.
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall
complete the work and provide all goods, materials, and services by completion of the Softball
Season, Septemeber 30, 2013.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed 1
person/multiple games-$33.00 per game; 2 person/multiple games-$56.00 per game, including
applicable Washington State Sales Tax, for the goods, materials, and services contemplated in
this Agreement. The City shall pay the Vendor the following amounts according to the following
schedule:
GOODS & SERVICES AGREEMENT - 1
(Over$10,000.00, including WSST)
m
King County/ASA Umpire Association will submit an itemized invoice of games
worked, umpires per game and fee incurred. Invoice may be divided into portions
of the season, either on a monthly or bi-monthly schedule or one invoice for the
entire program/season.
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves
the option to only pay that portion of the invoice not in dispute. In that event, the parties will
immediately make every effort to settle the disputed portion.
A. Defective or Unauthorized Work. The City reserves its right to withhold payment
from Vendor for any defective or unauthorized goods, materials or services. If
Vendor is unable, for any reason, to complete any part of this Agreement, the City
may obtain the goods, materials or services from other sources, and Vendor shall
be liable to the City for any additional costs incurred by the City. "Additional costs"
shall mean all reasonable costs, including legal costs and attorney fees, incurred by
the City beyond the maximum Agreement price specified above. The City further
reserves its right to deduct these additional costs incurred to complete this
Agreement with other sources, from any and all amounts due or to become due the
Vendor.
B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT
SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND
PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME
REQUEST FOR FINAL PAYMENT IS MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement. By their execution of this
Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following
representations:
A. The Vendor has the ability to control and direct the performance and details
of its work, the City being interested only in the results obtained under this
Agreement.
B. The Vendor maintains and pays for its own place of business from which
Vendor's services under this Agreement will be performed.
C. The Vendor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the
City retained Vendor's services, or the Vendor is engaged in an
independently established trade, occupation, profession, or business of the
same nature as that involved under this Agreement.
D. The Vendor is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
GOODS & SERVICES AGREEMENT - 2
(Over$10,000.00, including WSST)
E. The Vendor has registered its business and established an account with the
state Department of Revenue and other state agencies as may be required
by Vendor's business, and has obtained a Unified Business Identifier (UBI)
number from the State of Washington.
F. The Vendor maintains a set of books dedicated to the expenses and earnings
of its business.
V. TERMINATION. Either party may terminate this Agreement, with or without
cause, upon providing the other party thirty (30) days written notice at its address set forth on
the signature block of this Agreement.
VI. CHANGES. The City may issue a written amendment for any change in the goods,
materials or services to be provided during the performance of this 'Agreement. If the Vendor
determines, for any reason, that an amendment is necessary, Vendor must submit a written
amendment request to the person listed in the notice provision section of this Agreement,
section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have
known of the facts and events giving rise to the requested change. If the City determines that
the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the
Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will
determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the
amended work upon receiving either a written amendment from the City or an oral order from
the City before actually receiving the written amendment. If the Vendor fails to require an
amendment within the time allowed, the Vendor waives its right to make any claim or submit
subsequent amendment requests for that portion of the contract work. If the Vendor disagrees
with the equitable adjustment, the Vendor must complete the amended work; however, the
Vendor may elect to protest the adjustment as provided in subsections A through E of Section
VII, Claims, below.
The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a
separate acceptance, or (3) not protesting in the way this section provides. An amendment that
is accepted by Vendor as provided in this section shall constitute full payment and final
settlement of all claims for contract time and for direct, indirect and consequential costs,
including costs of delays related to any work, either covered or affected by the change.
VII. CLAIMS. If the Vendor disagrees with anything required by an amendment,
another written order, or an oral order from the City, including any direction, instruction,
interpretation, or determination by the City, the Vendor may file a claim as provided in this
section. The Vendor shall give written notice to the City of all claims within fourteen (14)
calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14)
calendar days of the date the Vendor knew or should have known of the facts or events giving
rise to the claim, whichever occurs first . Any claim for damages, additional payment for any
reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively
deemed to have been waived by the Vendor unless a timely written claim is made in strict
accordance with the applicable provisions of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in
subsections A, items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
GOODS & SERVICES AGREEMENT - 3
(Over$10,000.00, including WSST)
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS
SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that
estimate was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred
as a result of the asserted events giving rise to the claim. The City shall have
access to any of the Vendor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are
followed. If the City determines that a claim is valid, the City will adjust payment
for work or time by an equitable adjustment. No adjustment will be made for an
invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall
proceed promptly to provide the goods, materials and services required by the City
under this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides,
the Vendor also waives any additional entitlement and accepts from the City any
written or oral order (including directions, instructions, interpretations, and
determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures
of this section, the Vendor completely waives any claims for protested work and
accepts from the City any written or oral order (including directions, instructions,
interpretations, and determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM
THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT
SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY
LIMITATIONS PERIOD.
IX. WARRANTY. This Agreement is subject to all warranty provisions established
under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants
goods are merchantable, are fit for the particular purpose for which they were obtained, and will
perform in accordance with their specifications and Vendor's representations to City. The Vendor
shall correct all defects in workmanship and materials within one (1) year from the date of the
City's acceptance of the Contract work. In the event any part of the goods are repaired, only
original replacement parts shall be used—rebuilt or used parts will not be acceptable. When
defects are corrected, the warranty for that portion of the work shall extend for one (1) year
from the date such correction is completed and accepted by the City. The Vendor shall begin to
GOODS & SERVICES AGREEMENT - 4
(Over$10,000.00, including WSST)
correct any defects within seven (7) calendar days of its receipt of notice from the City of the
defect. If the Vendor does not accomplish the corrections within a reasonable time as
determined by the City, the City may complete the corrections and the Vendor shall pay all costs
incurred by the City in order to accomplish the correction.
X. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on
behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age,
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
discriminate against any person who is qualified and available to perform the work to which the
employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy
Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract
work, file the attached Compliance Statement.
XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
connection with the Vendor's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY
UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS
INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this
Agreement.
XII. INSURANCE. The Vendor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit A attached and
incorporated by this reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors
in the performance of the contract work and shall utilize all protection necessary for that
purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any
loss of or damage to materials, tools, or other articles used or held for use in connection with the
work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City
requires its contractors and consultants to use recycled and recyclable products whenever
practicable. A price preference may be available for any designated recycled product.
GOODS & SERVICES AGREEMENT - 5
(Over$10,000.00, including WSST)
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of
any of the covenants and agreements contained in this Agreement, or to exercise any option
conferred by this Agreement in one or more instances shall not be construed to be a waiver or
relinquishment of those covenants, agreements or options, and the same shall be and remain in
full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by
and construed in accordance with the laws of the State of Washington. If the parties are unable
to settle any dispute, difference or claim arising from the parties' performance of this
Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by
filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court,
King County, Washington, unless the parties agree in writing to an alternative dispute resolution
process. In any claim or lawsuit for damages arising from the parties' performance of this
Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or
bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award
provided by law; provided, however, nothing in this paragraph shall be construed to limit the
City's right to indemnification under Section XI of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the
parties at the addresses listed on the signature page of the Agreement, unless notified to the
contrary. Any written notice hereunder shall become effective three (3) business days after the
date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to
the addressee at the address stated in this Agreement or such other address as may be
hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written
consent of the non-assigning party shall be void. If the non-assigning party gives its consent to
any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of
the City and Vendor.
G. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or
other representative of the City, and such statements shall not be effective or be construed as
entering into or forming a part of or altering in any manner this Agreement. All of the above
documents are hereby made a part of this Agreement. However, should any language in any of
the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms
of this Agreement shall prevail.
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
to Vendor's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the performance of those operations.
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
GOODS & SERVICES AGREEMENT - 6
(Over$10,000.00, including WSST)
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
VENDOR: CITY OF KENT:
By. By. bxir
(signaturej, (sia ature 1I
Print Name. Print Name:_, _ GT
Its Its PT.� t�EGpAr�orJ Q Cu�rV�4� 2✓+
(t t/e)
DATE: r1e) DATE: -1te -13
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Jim Oswald David E. Heldt/Kent Commons
King County/ASA Umpires Association City of Kent
605 Cedar DR SE 220 Fourth Avenue South
Auburn, WA 98002 Kent, WA 98032
253-931-8185 (telephone) (253) 856-5000 (telephone)
253-395-7935 (facsimile) (253) 856-6000 (facsimile)
APPROVED AS TO FORM:
Kent Law Department
[In this field,you may enter the electronic filepath where the contract has been saved] '
GOODS & SERVICES AGREEMENT - 7
(Over$10,000.00, ]ncludrng WSST)
DECLARATION
Q CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of 200 3 .
By:
For: - Witu lack
Title: /J I /lELi
Date:
EEO COMPLIANCE DOCUMENTS - 1 of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2 of 3
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of��i,>r& _ �wmu U TDW
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on the_
(date) 4-" , between the firm I represent and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
Dated this day of , 200_.
By: n
For: l".60
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3 of 3
Exhibit A
Insurance Requirements for Umpires Agreement
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of this Agreement by
the Contractor, their agents, representatives, employees or subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on ISO
occurrence form CGT 00 01 and shall cover liability arising from
premises, operations, independent contractors, personal injury
and advertising injury, and liability assumed under the insured
contract. The Commercial General Liability insurance shall be
endorsed to provide the Aggregate Per Project Endorsement ISO
form CG 25 03 11 85.
2. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with the
limits no less than $2,000,000 per each occurrence, 2,000,000
general aggregate.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Commercial General Liability insurance:
1. The Contractor's insurance coverage shall be primary insurance
as respect the City. Any Insurance, self-insurance, insurance
pool coverage maintained by the City shall be excess of the
Contractor's insurance and shall not contribute with it.
2. The Contractor's insurance shall be endorsed to state that
coverage shall not be cancelled by either party, except after
thirty (30) days prior written notice by certified mail, return
receipt requested, has been given to the City.
3. The City of Kent shall be named as an additional insured on all
policies (except Professional Liability) as respects work
performed by or on behalf of the contractor and a copy of the
endorsement naming the City as additional insured shall be
attached to the Certificate of Insurance.
4. City reserves the right to receive a certified copy of all required
insurance policies. The Contractor's Commercial Liability
insurance shall also contain a clause stating that coverage shall
apply separately to each insured against whom claim is made or
suit is brought, except with respects to the limits of the insurer's
liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the Agreement.
F. Subcontractors
Contractor shall include all subcontractors as insured under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverage's for the subcontractors shall be subject to all of the same
insurance requirements as state herein for the Contractor.
CERTIFICATE OF LIABILITY INSURANCE DATE
02/04/13 )
ACtJ2 D
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE
OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT If the certificate holder Is an ADDITIONAL INSURED,the policy(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,
certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements)
PRODUCER CONTACT
Bollinger,Inc. nlc N 800.526.1379 NE FAIC, 973.921-2876
101 JFK Parkway E MAIL
Short Hills,NJ 07078-5000 ADDRESS
PRODUCER
CUSTOMER I❑
INSURERS)AFFORDING COVERAGE NAICk
INSURED AMATEUR SOFTBALL ASSOCIATION INSURER MARKEL INSURANCE COMPANY 38970
OF AMERICA INSURER H
2801 NORTHEAST SOth STREET INSURER c,
OKLAHOMA CITY,OK 73111
INSURER Di i
INSURER E•
INSURER F
COVERAGES CERTIFICATE NUMBER: 46528 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO'JJ HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED
NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUPAENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAYPERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES
LIMITS SHOIAIN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR TYPEOFINSURANCE INSR SUe POLICYNUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR ^ D M 8 fD
GENERAL LIABILITY EACH OCCURRENCE $2,000,000
ASEE
A X COMMERCIAL GENERAL LIABILITY 3602AH230069-12 ATTACHED 01/01I14 DAIIA ET RENTED i
PRE
300 000
CLAIMS MADE a OCCUR MED EXP(Ary one person) 10 000"` i
X Inel Participants PERSONAL&ADV INJURY 2 000 000 I
"Non participants only
I GENERAL AGGREGATE 5000000
CENL AGGREGATE LIMIT APPLIES PER PRODUCTS-CCMPIOP AGG $2,000,000
POLICY QPRO.ECT LOG
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Fa accident)
ANY AUTO
BODILY INJJRY(Per person)
ALL OWN ED SCHEDULED
AUTOS AUTOS BODILY INJ'JRY(Per a¢ident)
HIRED AUTOS NON-OWNED PROPERTY DAMAGE
AUTOS (Per aaident)
i
UMBRELLALIAe OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS MADE AGGREGATE
DFO F I RETEI, $
WORKER'S COMPENSATION vx STAWu ahER
AND EdPLOYERS'LIABILITY YIN TORYINITS
ANY PRCPRIETORIPARTNEWEXECUTNE ❑ NIA EL EACH ACCIDENT
OFFICERTlEMSER EXCLUDED?
(Mandatory In NH) EL DISEASE-EA EMPLOYEE
f yes,doscnbe-under
DESCRIPTION OF CPERATIONS Le'u& E L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORO 101,Additional Remarks Schedule,If more space Is required)
SEE ATTACHED
CERTIFICATE HOLDER CANCELLATION
City of Kent,WA Dave
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Dave Neldt EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
525 4th Avenue North THE POLICY PROVISIONS.
Kent,WA 98032
AUTHORIZED REPRESENTATIVE +
I
01988-2009 ACORD CORPORATION All rights reserved
ACORD 28(2010105) The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - FIELD OWNER
FOR AMATEUR SOFTBALL ASSOCIATION OF AMERICA ACTIVITIES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement
Named Insured _
As shown on the attached Certificate of Insurance
Policy Number Policy Period Endorsement Effective Date
3602AH230069-12 01/01/13-01/01/14 As shown on the attached certificate of Insurance
Issued By rized Representafroe '
MARKEL INSURANCE COMPANY
(7he above information rs requved only when this endorsement is prepared after To polrcy is Issued)
SCHEDULE
NAME OF FIELD OWNER: PREMIUM
As shown on the attached Certificate of Insurance $ Included
A The following is added to Section 11—WHO IS AN INSURED
The person or organization shown in the above SCHEDULE but only with respect to liability arising out
of Amateur Softball Association of America sponsored games, practices, and tournaments emanating
from the field of play or occurring on the field of play
All other terms and conditions of this policy remain unchanged.
I
I
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19 60 GL 10 00 Includes copyrighted material of Insurance Services Office,Inc with its permission Page 1 of t
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